Provider Demographics
NPI:1235542978
Name:NIVER, SHANNON (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:NIVER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 ORCHARD PARK RD STE C
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2656
Mailing Address - Country:US
Mailing Address - Phone:716-558-5150
Mailing Address - Fax:716-677-2845
Practice Address - Street 1:550 ORCHARD PARK RD STE C
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2656
Practice Address - Country:US
Practice Address - Phone:716-558-5150
Practice Address - Fax:716-677-2845
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7756082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist